Management of Pregnancy during the COVID‐19 Pandemic

Abstract

Coronavirus disease 2019 (COVID‐19) is spreading worldwide. All aspects of pregnancy management from conception to delivery to puerperium as risks facing newborns are herein, reviewed. Maternal home management and prenatal care management protection, delivery timing or mode selection, delivery process management, and subsequent puerperal protection are crucial. In this Review, the features and treatment strategies, especially emphasizing the safety of antiviral drugs for pregnant women, the wearing of face masks, and practicing of personal hygiene (e.g., handwashing, disinfection, home cleaning, and ventilation) are reviewed as essential protective measures. It is recommended to provide online consultation, telemedicine, and remote fetal heart rate monitoring and set the flow point for prenatal examination to encourage prenatal examination at home or postponing examinations (except nuchal translucency at 11‐13+6 weeks, Oscar Test at 16 weeks, and fetal ultrasound at 20–24 weeks). It is shown that the precise formulation of follow‐up strategies for pregnant women with COVID‐19 is necessary.

Management and Prevention of COVID-19 in Pregnancy and Pandemic Obstetric Care: A Review of Current Practices

“…HCWs should consider the possibility of a false-negative result after qRT-PCR testing, as most commercially available assays interpret the result with a qualitative method [ 26 ]. Additionally, there is a possibility of a false-positive result with a positive predictive value ranging from 47.3% to 96.8% and a negative predictive value from 96.8% to 99.9% [ 27 ]. The sensitivity could be increased with the combination of an IgM ELISA assay with a qRT-PCR test [ 28 ].…”

“…The sensitivity could be increased with the combination of an IgM ELISA assay with a qRT-PCR test [ 28 ]. However, antibody tests alone are inferior in detecting the acute onset of infection [ 27 , 28 ]. If the result is negative, but clinical suspicion remains high, qRT-PCR should be repeated after 24 h [ 6 , 25 , 26 ].…”

“…Nevertheless, such a measure may be accompanied by certain deficits, when for example during the home “isolation”, pregnant women inattentively interact with their family members. Practical suggestions to prevent the potential of viral transmission by a family member include the wearing of face masks, regular disinfection of high contact surfaces with >60% ethanol, regular handwashing, and use of disposable–personal items [ 27 ]. These measures should be applied by both pregnant women and their household partners [ 28 ].…”

“…However, as the data remain limited, the probability of vertical transmission cannot be ruled out as yet [ 41 ]. Certain precautions should be taken, as the newborns may also acquire the infection after delivery [ 27 , 38 ]. It is prudent to avoid fetal scalp pH examination, internal fetal heart rate monitoring, and routine umbilical cord gas analysis [ 33 ].…”

Implementation of e-SEKOCI (The Online Class of Sekolah Komplementer Cinta Ibu) in counselling midwives and pregnant women during COVID-19 pandemic

“…Limited direct access to clinics, Public Health Centers, or hospitals today should not reduce the quality of health services provided. 12,13 Some previous studies have used tele-health, health applications, or social media as a means to provide these health services. 14 In this study, we use social media WhatsApp group, Instagram, YouTube, and Zoom Cloud meetings in the implementation of education and health consultation.…”